Payment Setup is critical to the Interim Payment process because it affects the "who" and "how" of reporting costs and requesting payments. Figuratively, it is about "getting your ducks in a row."

Payment Setup is the process by which the Plan Sponsor determines who reports cost data for each Benefit Option on the Application, how the information is transmitted to CMS' RDS Center, and who requests interim payments if the Plan Sponsor has selected an Interim Payment frequency.

During the Payment Setup process, the Plan Sponsor is asked to identify individuals and/or Vendors that are responsible for reporting costs associated with each Benefit Option and requesting payments for an approved Application.

The Payment Process consists of six steps:

1. Assign Payment Requester Privilege to Authorized Representative
2. Assign Payment/Cost Privilege to Account Manager
3. Assign Payment/Cost Privilege to Designee(s)
4. Specify Vendors for Cost Reporting
5. Assign Benefit Options to Cost Reporters
6. Final Review to Complete Payment Setup

The Application must be in an Approved status before a Plan Sponsor can initiate Payment Setup. All six steps of Payment Setup must be complete to finalize Payment Setup. Plan Sponsors cannot submit Cost Reports or Payment Requests until Payment Setup has been completed.

Before initiating Payment Setup, there are some guidelines that you must understand:

• The same person cannot be both a Payment Requester and Cost Reporter. This means that a single individual may not have both the Report Costs privilege and the Request Payment privilege on a given Application. A Cost Reporter cannot request payments, and a Payment Requester cannot report costs. This separation of duties is to guard the RDS Program against fraud and protect taxpayer dollars. The RDS Secure Website enforces this separation of duties requirement during the Payment Setup process.
• Possible Payment Requesters can include: Authorized Representatives (which are required by the system); Account Managers assigned Request Payment privilege; and Designees assigned Request Payment privilege.
• Possible Cost Reporters can include: Account Managers assigned Report Costs privilege; Designees assigned Report Costs privilege, and Vendors. Vendors can report cost data, but they can never request payments.
• Cost Reporter Designees attached to Vendors are considered Vendor Designees.
• Cost Reporter Designees not attached to Vendors are considered Plan Sponsor Designees. This means that when you set up Cost Reporter Designees in Payment Setup, you want to make sure that your Designees are attached to the appropriate source.
• Cost Reporters must be assigned a Reporting Method. There are two reporting methods: Mainframe and Data Entry.
• Plan Sponsor Cost Reporters must be assigned the same Reporting Method. This means that Plan Sponsor Cost Reporters must either submit cost data by Data Entry or by Mainframe, but not using both methods on the same Application. 
• At least one Cost Reporter must be assigned to each Benefit Option.
• Plan Sponsor and Vendor Cost Reporters are separate sources. The source becomes particularly important if you have multiple Cost Reporters reporting on the same Benefit Option for the same plan month. Cost data reported by the same source overlays, while cost data reported by different sources are added together. 
• All six Payment Setup steps must be completed to finalize Payment Setup.
• Payment Setup must be completed to report costs or request payment.

There are two methods to submit Cost Reports to CMS' RDS Center: (1) Manual Data Entry using the RDS Secure Website and (2) Mainframe. All steps of Payment Setup must be complete to submit Cost Reports. If Payment Setup is not complete, Data Entry Cost Reporters will be unable to enter costs and Mainframe Cost Reports will be rejected by CMS' RDS Center.

Manual Data Entry Using The RDS Secure Website

The Manual Data Entry process requires a user to access the RDS Secure Website. The aggregated retiree cost data per Benefit Option and plan month is then manually entered.

RDS Center Mainframe Submission

The Mainframe process requires a Vendor or a Plan Sponsor to submit aggregated retiree cost data per Benefit Option and plan month using a Mainframe to Mainframe connection. Cost data sent using the Mainframe is viewable in the RDS Secure Website if basic format edits are passed; however, you are unable to change cost data reported using the Mainframe using the RDS Secure Website. To revise cost data submitted using the Mainframe, you must submit revised cost data files using the Mainframe connection and then the new data displays on the RDS Secure Website.

If you are using a Vendor to report costs using the Mainframe, you may assign one of their employees as a Designee with the Report Costs privilege (for example, an RDS Secure Website user) so the Vendor may view the cost report data that the Vendor submitted on the RDS Secure Website. The Designee must establish a RDS Secure Website user account by completing Registration to view the cost data submitted by the Vendor.

RDS User Roles And Responsibilities

Authorized Representative And Account Manager

The Authorized Representative and/or Account Manager are the only RDS Secure Website user roles that have the authority to perform Payment Setup. The Authorized Representative and/or Account Manager are required to complete each of the six Payment Setup steps, and submit the completed Payment Setup to CMS' RDS Center for processing.

A single individual may not have both the Report Costs privilege and the Request Payment privilege on a given Application. A Cost Reporter cannot request payments, and a Payment Requester cannot report costs. This separation of duties protects the RDS Program against fraud, and protects taxpayer dollars. The RDS Secure Website enforces this separation of duties requirement during the Payment Setup process.

Consequently, the Authorized Representative is always a Payment Requester on an Application, and can never report costs. Likewise, the Account Manager must decide if they want to report costs or request payment - but they cannot perform both payment-related privileges in the same Application. The separation of duties requirement is at an Application level so it is possible for an Account Manager or Designee to report costs on one Application, and request payment on another, if necessary.

Since the Authorized Representative is the only individual who may submit the annual Payment Request or Reconciliation payment request, they will always have the Request Payment privilege. During the Payment Setup process, the Authorized Representative is automatically granted the Request Payment privilege and, therefore, cannot also be a Cost Reporter. In addition, the Authorized Representative has the ability to review interim costs and view Final Cost Reports for all Benefit Options. The Authorized Representative does not have the ability to report costs for any Benefit Option.

Since the same individual cannot report costs and request payment for the same Application, during the Payment Setup process, you are asked to identify the payment-related privilege for the Account Manager. The Account Manager can either: request payment and consequently only view cost data, or report costs and consequently only view payment data, or only view both cost and payment data.

Designees

A Designee can be assigned either the Report Costs privilege or the Request Payment privilege, but not both in the same Application. You can either decide to assign Report Costs privileges or Request Payment privileges to existing Designees already assigned to the Application, or you can assign new Designees during the Payment Setup process.

Designees assigned the Report Costs privilege has the ability to view cost data for their assigned Benefit Options. Designees may enter costs for the associated Benefit Options if assigned the Data Entry reporting method or assigned to a Vendor with the Data Entry reporting method.

Designees assigned the Request Payment privilege are permitted to submit Interim Payment Requests, review interim and final costs when preparing the payment request, and view all Cost Reports for that Application.

Plan Sponsors that want Vendors to report cost data using the Data Entry reporting method will need to assign an employee of the Vendor as a Designee. You are not required to assign Designees as Cost Reporters or Payment Requesters - this is only necessary if someone other than the Authorized Representative and the Account Manager is handling either one of these payment privileges.

You must have at least one Cost Reporter assigned to each Benefit Option. If a Vendor reporting by the Data Entry reporting method is assigned as a Cost Reporter, a Designee must be assigned to the Vendor. If the Account Manager is not reporting costs, then a Designee and/or Vendor must be assigned as a Cost Reporter.

System-Specific Roles And Responsibilities

Cost Reporter

A Cost Reporter is an individual, or a Vendor, that is responsible for submitting drug cost data to CMS' RDS Center. During the Payment Setup process, you identify Cost Reporters for each Benefit Option defined within an Application. You may choose to make any of the following Cost Reporters: the Account Manager, any existing Designees already assigned to the Application, any new Designees you would like to add to the Application, or a Vendor(s). Cost Reporters are assigned for each Benefit Option within an Application, and each Benefit Option must have a Cost Reporter for the Payment Setup process to be complete.

There are two sources that can submit cost data: the Plan Sponsor and the Vendor. A Plan Sponsor is considered a single source regardless of the number of individual Cost Reporters assigned to the Plan Sponsor, and a Vendor is considered a single source regardless of the number of individual Cost Reporters assigned to the Vendor. 

Note: Plan Sponsor Cost Reporters and Vendor Cost Reporters are separate sources. Source becomes particularly important if you have multiple Cost Reporters reporting on the same Benefit Option for the same plan month. Cost data reported by the same source overlays, while cost data reported by different sources are added together.

Payment Requester

A Payment Requester is an individual that has been granted the permission to build and submit Interim Payment Requests and prepare the Final Payment Request using the RDS Secure Website. Only the Authorized Representative can submit the final Reconciliation payment request. The Authorized Representative always has the Request Payment privilege for all the Applications to which they are assigned. The Account Manager and Designees may also be assigned the Request Payment privilege, for submitting Interim Payment Requests. The Payment Requester privilege is assigned at the Application level.

Vendor

A Vendor is a Pharmacy Benefit Manager (PBM), Health Plan, or another third party company that has been contracted by a Plan Sponsor to report costs. During the Payment Setup process, a Plan Sponsor is asked to specify any Vendors that are reporting costs for the Application based on the Vendor ID. Using a Vendor to report cost data is optional.

A Vendor may report costs using the RDS Secure Website or Mainframe connection.

A Vendor is required to request a Vendor ID from CMS' RDS Center, and each Vendor ID has a pre-associated cost report submission method as specified by the Vendor.

For example, if Vendor ABC is reporting costs for Application number 12345 using the Mainframe reporting method, Vendor ABC needs to request a Vendor ID from CMS' RDS Center for the Mainframe reporting method. If Vendor ABC is also reporting costs for Application 67890 using the Data Entry reporting method, they need to request an additional Vendor ID associated with the Data Entry reporting method.

A Vendor that wants to initiate the Registration process and request a Vendor ID for the RDS Secure Website needs to contact CMS' RDS Center Help Line. After the Vendor receives the Vendor ID, he must communicate the Vendor ID to the appropriate Plan Sponsors, so it can be entered in Payment Setup on the RDS Secure Website as applicable.

Plan Sponsor Designee Cost Reporter/Vendor Designee Cost Reporter Differences

A Vendor Designee Cost Reporter is an individual that is associated with a specific Vendor ID. By associating a Designee with a Vendor, the Designee is given permission to view or report cost data on behalf of the Vendor. A Plan Sponsor Designee Cost Reporter is an individual assigned the Report Costs privilege for a Benefit Option that is not assigned a Vendor ID. A Plan Sponsor Designee does not have access to any Vendor Costs Reports. A Vendor Designee does not have access to any Cost Reports reported by the Account Manager, Plan Sponsor Designee, or another Vendor.

At least one Cost Reporter must be assigned to each Benefit Option; however, a single Benefit Option may have more than one Cost Reporter. The Cost Reporters could be two different Vendor IDs, two different Plan Sponsor Cost Reporters, or a combination of the two.

Each Plan Sponsor Cost Reporter must be assigned a reporting method. If multiple Plan Sponsor Cost Reporters are reporting costs for the same Application, they must all use the same reporting method. They must all use the Mainframe or Data Entry reporting method—not a combination of the two. This only applies to cost data being reported by multiple Plan Sponsor Cost Reporters, and not to Vendors. Vendor Designees inherit the reporting method from their Vendor. A reporting method is not assigned directly to a Vendor Designee.

Payment Setup is only available when an Application in an Approved status.

If an Application has been approved, the Application Status field displays “Approved.” If the Authorized Representative and Account Manager do not have access to the Payment Setup Menu page, contact CMS' RDS Center Help Line for assistance.

To access the RDS Secure Website and navigate to the Application List page, go to: Appendix A: Access the RDS Secure Website in the RDS User Guide.

From the Application List page:

1. Find the appropriate Application Number.
2. Select Payment Setup from the Actions dropdown menu and select the Go button or select the Payment Setup link in the Payment Setup Status column..

Note: You do not have access to Payment Setup until your Application is in an Approved status.

On the Payment Setup page:

3. To view the details of the selected Payment Setup, select the View Payment Setup Options link.
4. To complete Payment Setup, select each of the Payment Setup Step links in the Payment Setup Menu.

Step 1 is automatically completed. This is because the Authorized Representative's payment-related privilege always defaults to the Request Payment privilege, and cannot be changed. However, the Authorized Representative is not required to request interim payments. As you will see in the following steps, the Account Manager or a Designee can also be assigned the Request Payment privilege for an Application.

Purpose of Step 2: Assign Payment/Cost Privilege to Account Manager

In Step 2, the Plan Sponsor is required to assign the Account Manager one of the following privileges: Request Payment, Report Costs, or View Only. The Plan Sponsor must select one of these options.

An Account Manager can either: request payment and consequently only view cost data, or report costs and consequently only view payment data, or only view both cost and payment data.

• Request Payment: The Request Payment privilege allows the Account Manager to request interim payments for the given Application. If the Account Manager is requesting payments, you need to select this option.
• Report Costs: The Report Cost privilege allows the Account Manager to report interim costs for the given Application. If the Account Manager is reporting costs, you need to select this option.
• View Only: The View Only privilege allows the Account Manager to view interim costs and Interim Payment Requests. If the Account Manager will not be reporting costs or requesting payment but oversees these activities, you need to select this option.

Assign Payment/Cost Privilege To Account Manager

To access Step 2: Assign Payment/Cost Privilege To Account Manager, go to: Access The Payment Setup Menu.

On the Assign Payment/Cost Privilege to Account Manager page:

An asterisk (*) indicates a required field.

1. *Select the appropriate radio button: Request Payment, Report Costs, or View Only.
2. Select the Continue button to proceed or select the Cancel button to return to the Payment Setup Menu page without saving your selection.

On the Assign Payment/Cost Privilege to Account Manager Confirmation page:

3. Select the Continue button to proceed or select the Cancel button to return to the Payment Setup Menu page without saving your selection.

Purpose of Step 3: Assign Payment/Cost Privilege To Designee(s)

In Step 3, the Plan Sponsor may choose to assign Plan Sponsor Designees with Request Payment or Report Costs privilege. If the Plan Sponsor is using Designees, the Designees must be identified in this step if they were not already identified in the Application Submission Process. A Designee is an optional registered RDS participant used to complete tasks in the RDS Program Lifecycle to assist the Plan Sponsor.

A Designee can be assigned either the Report Costs or the Request Payment privilege, but not both in the same Application. You can either decide to assign payment-related privileges to existing Designees that are already defined in the Application, or you can add new Designees during the Payment Setup process and assign them payment-related privileges.

Note:  A Designee must be assigned the Report Costs privilege in this step to report costs to CMS' RDS Center. A Designee must be assigned the Request Payment privilege in this step to request payment.

Assign Payment/Cost Privilege To Designee(s)

To access Step 3: Assign Payment/Cost Privilege To Designee(s), go to: Access The Payment Setup Menu.

On the Assign Payment/Cost Privilege to Designee(s) page:

An asterisk (*) indicates a required field.

1. *Select Yes to assign a new Designee, view Designee Payment/Cost privilege assignments, or maintain Designee privileges. or select No to return to Payment Setup Menu page.
2. Select the Continue button to proceed or select Cancel button to return to the Payment Setup Menu page.

Note: The Assign Payment/Cost Privilege to Designee(s) page allows the Plan Sponsor's Account Manager or Authorized Representative to indicate whether to assign Report Costs or Request Payment privileges to one or more Designees. You will only see this page if this question has never been answered for the appropriate Application when you select the "Assign Payment/Cost Privileges to Designee(s)" link on the Payment Setup Menu page. After your response to this question has been recorded, you will no longer see this page; instead, you will see a list of Designees already assigned to the Application.

On the Assign Designee Payment/Cost Privilege Summary page:

3. Select the Assign a Designee link to assign a new Designee or select the Continue button to return to the Payment Setup Menu page.

On the Assign Designee page:

An asterisk (*) indicates a required field.

4. *Enter the Designee's Email Address.
5. Select the Continue button to search for the email address or select the Cancel button to return to either the Application Status page or the Payment Setup Menu page.

Scenario #1: The Email Address is found but cannot be used to assign a Designee.

Possible Reasons: If the Email Address entered is associated with a user account that already has a different RDS Secure Website user role or if a user's RDS account is inactive.

On the Designee Cannot Use page:

6. Select the Continue button to return to the Assign Designee page to search again.

Scenario #2: The Email Address is not found and can be used to assign a Designee.

On the Designee Not Found page:

6. Select the Continue button to assign this new Designee or select the Cancel button to return to the Assign Designee page.

On the Assign New Designee page:

An asterisk (*) indicates a required field.

7. Enter the required information to assign a Designee: *First Name, Middle Name, *Last Name, *Pass Phrase, and *Re-enter Pass Phrase.
8. Select the Continue button to proceed to the Assign Designee Privileges page or select the Cancel button to return to the Assign Designee page. (Skip to instruction number 9.)

Scenario #3: The Email Address is found and can be used to assign a Designee.

On the Designee Found page:

6. Select the Continue button to assign this Designee and proceed to the Assign Designee Privileges page or select the Cancel button to return to the Assign Designee page. (Skip to instruction number 9.)

On the Assign Designee Privileges page:

9. In the Costs and Payment section, select the checkbox for the Report Costs privilege or the Request Payment privilege.

Note: A user may not report costs and request payments on the same Application.

10. Select the Continue button to proceed or select the Cancel button to return to the Assign Designee page.

On the E-PHI Agreement page:

11. Read the E-PHI Agreement. Select the Accept button to authorize the Designee to access or use E-PHI associated with their Plan Sponsor's RDS Application. Select the Decline button to return to the Assign Designee Privileges page.

Note: To read the E-PHI Agreement, go to: Appendix D: E-PHI Agreement.

On the Assign Designee Verification page:

12. Select the Confirm button to assign the Designee or select the Cancel button to return to the Assign Designee Privileges page.

On the Assign Designee Confirmation page:

13. Select the Continue button to return to the Assign Designee Payment/Cost Privilege Summary page.

Change Designee Privileges

A Designee can be assigned the Report Costs privilege or the Request Payment privilege, but not both in the same Application. A Plan Sponsor can decide to assign these payment-related privileges to existing Designees already defined in the Application, or add new Designees during the Payment Setup process and assign them a payment-related privilege.

To access Step 3: Assign Payment/Cost Privilege To Designee(s), go to: Access The Payment Setup Menu.

On the Assign Designee Payment/Cost Privilege Summary page:

1. Select the Designee Name link to access Designee Information and change a Designee's privileges.

On the Maintain Designee page:

2. Select the Change Privileges button to change a Designee's privileges or Select the Cancel button to return to the Assign Designee Payment/Cost Privilege Summary page.

On the Change Designee Privileges page:

3. In the Costs and Payment section, select the checkbox for the Report Costs privilege or the Request Payment privilege.

Note: A user may not report costs and request payments on the same Application.

4. Select the Continue button to proceed or select the Cancel button to return to the Maintain Designee page.

On the E-PHI Agreement page:

5. Read the E-PHI Agreement. Select the Accept button to authorize the Designee to access or use E-PHI associated with their Plan Sponsor's RDS Application or select the Decline button to return to the Change Designee Privileges page.

Note: To read the E-PHI Agreement, go to: Appendix D: E-PHI Agreement. in the RDS User Guide

On the Change Designee Privileges Verification page:

6. Select the Confirm button to assign privileges to the Designee or Select the Cancel button to return to the Change Designee Privileges page.

On the Change Designee Privileges Confirmation page:

7. Select the Continue button to return to the Assign Designee Payment/Cost Privilege Summary page.

Delete A Designee

Note: If the Designee is assigned to the Vendor, the Vendor assignment must first be removed before deleting the Designee. If the Designee is assigned to one or more Benefit Options but has not reported costs, the assignments must be removed before deleting the Designee. If the Designee has reported costs, the Designee can be deleted without removing the assignments.

To access Step 3: Assign Payment/Cost Privilege To Designee(s), go to: Access The Payment Setup Menu.

On the Assign Designee Payment/Cost Privilege Summary page:

1. Select the Designee Name link to access Designee Information and delete a Designee.

On the Maintain Designee page:

2. Select the Delete Designee button to delete a Designee or Select the Cancel button to return to the Assign Designee Payment/Cost Privilege Summary page.

On the Delete Designee Verification page:

3. Select the Confirm button to delete this Designee or select the Cancel button to return to the Maintain Designee page.

On the Delete Designee Confirmation page:

4. Select the Continue button to return to the Assign Designee Payment/Cost Privilege Summary page.

Purpose of Step 4: Specify Vendors For Cost Reporting

In Step 4, the Plan Sponsor may choose to assign Vendors for cost reporting. If the Plan Sponsor selects "Yes," they are prompted to identify Vendors and Vendor Designees.

A Vendor may report cost data using Mainframe or Data Entry. A Vendor is required to request a Vendor ID from CMS' RDS Center. Each Vendor ID has a pre-associated cost data submission method as specified by the Vendor. For example, a Vendor wanting to report costs using Mainframe for one Application may have Vendor ID A12345 for Mainframe and Vendor ID A56789 for Data Entry.

Establishing a Vendor Cost Reporter with CMS' RDS Center in Step 4 of Payment Setup

To specify a Vendor in Step 4, you need the Vendor ID. The Vendor ID is an identification number assigned to a Vendor by CMS' RDS Center as a form of verification of the Vendor's contract with the Plan Sponsor. If you do not know the Vendor ID, contact the Vendor directly for this information. Make sure you clarify with the Vendor, which cost reporting submission method you would like them to use. The Vendor ID may vary depending on whether the Vendor is reporting Mainframe or Data Entry.

For each Vendor assigned, you need to let CMS' RDS Center know if you plan on having a Designee view the Cost Reports submitted by the specific Vendor. Vendor Designees are required if a Vendor is reporting by the Data Entry method, but are not required for Mainframe.

Given that rejected Mainframe Cost Reports do not communicate any messages of failure, the Retiree Drug Subsidy (RDS) Community Information Group (CIG) recommends that Plan Sponsors assign a Vendor Designee the Report Costs privilege so that they can verify that Cost Reports submitted by Mainframe were accepted.

Specify Vendors For Cost Reporting

To access Step 4: Specify Vendors For Cost Reporting, go to: Access The Payment Setup Menu.

On the Specify Vendor(s) for Cost Reporting page:

An asterisk (*) indicates a required field.

1. *To specify a Vendor, select the Yes radio button and select the Continue button to proceed. (If you do not want to specify a Vendor, select No and select the Continue button). Select the Cancel button to return to the Payment Setup Menu page without completing this step.

Note: You must select "Yes" or "No" to complete this step. If you select No radio button, Step 4 is complete and no other information is necessary. If you select Yes radio button, you will be asked to provide additional information about the Vendor.

On the Vendor Summary page:

2. Select the Specify a Vendor link to specify a Vendor to report costs for this Application or select the Continue button to return to the Payment Setup Menu page.

On the Specify Vendor page:

3. Enter the Vendor ID and select the Go button.

Note: If you do not know the Vendor ID, contact the Vendor directly for this information. Make sure you clarify with the Vendor which reporting method you would like them to use. The Vendor ID may vary depending on whether the Vendor is reporting using Mainframe or Data Entry.

On the Specify Vendor page:

4. If the Vendor ID was found and you have confirmed that the information listed is correct, select the Assign button. Select the Modify Search button to return to the Specify Vendor page and search for another Vendor ID.

On the Vendor Summary page:

5. Select the Identify Vendor Cost Reporters link in the Cost Reporters column or select Identify Cost Reporters from the Actions dropdown menu and select the Go button.

Note: For each Vendor assigned, you need to indicate if you plan to allow a Designee to view the Cost Reports submitted by the specific Vendor. Assigning a Designee to view Cost Reports submitted by a Vendor is optional; however, answering the question is not. This question only appears if the Vendor is reporting using Mainframe. If the Vendor is reporting using Data Entry, they will proceed directly to the Identify Vendor Cost Reporters page.

On the Identify Vendor Cost Reporters page:

6. If the desired Designee is listed, select the appropriate checkbox next to their name, and then select the Continue button (you will return to the Vendor Summary page) or select the Cancel button to return to the Vendor Summary page without completing this step.

Note: If the Vendor reports costs using Mainframe, Vendor Cost Reporters are allowed to view on the RDS Secure Website those Cost Reports submitted by the Vendor for the Application. If the Vendor is reporting using the Data Entry reporting method, Vendor Cost Reporters are allowed to enter costs on the RDS Secure Website. A Vendor Cost Reporter must be assigned if the Vendor is reporting using the Data Entry reporting method.

If the desired Designee is not listed, select the Assign Designee(s) Payment Cost Privileges link to return to Step 3: Assign Payment/Cost Privilege to Designee(s).

Purpose of Step 5: Assign Benefit Options To Cost Reporters

In Step 5, for each Benefit Option, the Plan Sponsor is required to report to CMS' RDS Center who is providing the cost data for each Benefit Option.

Assign Benefit Options To Cost Reporters

To access Step 5: Assign Benefit Options To Cost Reporters, go to: Access The Payment Setup Menu.

On the Assign Benefit Options to Cost Reporters page:

1. Select Assign Benefit Options from the Actions dropdown menu and select the Go button.

On the Assign Benefit Options page:

2. To assign or unassign all listed Benefit Options, select the Assign All/Unassign All button. To assign individual Benefit Options, select the appropriate checkboxes.
3. Select the Continue button to proceed to the Assign Benefit Options to Cost Reporters page or select the Cancel button to delete your selection and return to the Assign Benefit Options to Cost Reporters page.

Specify Reporting Method

As part of the Payment Setup process, the Plan Sponsor needs to select the appropriate radio button next to the cost reporting method to assign to the Cost Reporter. The cost reporting method informs the RDS Program how the Cost Reporter is going to submit costs to CMS' RDS Center.

Note: A cost reporting method must be specified for each Cost Reporter to complete this step of Payment Setup. The cost reporting method for Vendors has been pre-assigned upon registering with CMS' RDS Center and cannot be modified.

To access Step 5: Assign Benefit Options To Cost Reporters, go to: Access The Payment Setup Menu.

On the Assign Benefit Options to Cost Reporters page:

1. Select Specify Reporting Method from the Actions dropdown menu and select the Go button.

On the Specify Reporting Method page:

2. Select the corresponding radio button to select Data Entry or Plan Sponsor Mainframe to RDS Center Mainframe through CMS Extranet. Select the Continue button to proceed or select the Cancel button to return to the Assign Benefit Options to Cost Reporters page.

On the Specify Reporting Method Confirmation page:

3. Select the Continue button to proceed to the Assign Benefit Options to Cost Reporters page. Select the Cancel button to delete your selection and return to the Assign Benefit Options to Cost Reporters page.

Purpose of Step 6: Final Review To Complete Payment Setup

In Step 6, the Plan Sponsor reviews and confirms Payment Setup. You can view the details of your selected Payment Setup assignments by clicking the View Payment Setup Options link on the Payment Setup Menu page at any time.

Final Review To Complete Payment Setup

To access Step 6: Final Review To Complete Payment Setup, go to: Access The Payment Setup Menu.

On the Review To Complete Payment Setup page:

1. Review each Payment Setup step to complete the final review.
2. If a step is "Incomplete," select the corresponding link to proceed to that step and complete it.
3. Select the Submit Payment Setup button after all steps are completed or select the Cancel button to return to the Payment Setup Menu.

On the Successful Payment Setup page:

4. Select the Continue button to return to the Payment Setup Menu page.

After Step 6: Final Review To Complete Payment Setup is complete, Payment Setup is “Complete”.

After the Cost Reporter has submitted a Cost Report, the following Payment Setup actions are disabled:

• Changing the Account Manager from Report Costs privilege to View Only or to Request Payment privilege
• Changing Plan Sponsor Designee from Report Costs privilege to Request Payment privilege
• Removing a Vendor
• Removing Benefit Options from Cost Reporters (Vendor or Plan Sponsor)

Changing Payment Setup

Note: Payment Setup is accessible from the Application List page until Reconciliation is initiated and after Reconciliation is complete. During Reconciliation, Payment Setup is only accessible from the Reconciliation Checklist.

CMS' RDS Center does not limit the number of times you can make changes to Payment Setup. However, Payment Setup must be completed before you can submit a Cost Report or make a Payment Request.

Before cost data is reported, anything can be changed in Payment Setup. It is not until after cost data has been reported that there are rules on what can be changed in Payment Setup.

Common mistakes to avoid in Payment Setup include the following:

• Not assigning a Vendor to a Benefit Option. When a Vendor is not assigned to a Benefit Option, the costs submitted by the Vendor are rejected, and the Designee for the Vendor is prohibited from entering cost data for the Benefit Option.
• Not attaching Designees to a Vendor. When a Designee is not attached to a Vendor, the Designee is considered a Plan Sponsor Designee. Plan Sponsor Designees do not have access to Vendor Cost Reports. If a Vendor is submitting Cost Reports through Data Entry, Payment Setup cannot be completed until a Cost Reporter Designee is assigned to a Vendor.
• Setting up both the Plan Sponsor and Vendor to report cost data on the same Benefit Option. When both the Plan Sponsor and Vendor report cost data on the same Benefit Option for the same plan month, the cost data are added together and potentially duplicated.
• Not completing Payment Setup. When Payment Setup is incomplete, cost data cannot be reported, Vendor files will be rejected, and Data Entry is prohibited on the RDS Secure Website.